内科学 消化系统总论-王吉耀.ppt

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1、DigestiveSystemIntroductionProf.JiyaoWangAssimilationofnutrientsEliminationofwasteStructureandfunctionsStructureandfunctionsThetwoactivitiesundervoluntarycontrolareswallowinganddefecation.CharacteristicsofDigestiveSystemManynormalGIreflexesinvolveextrinsicvagusorsplanchnicnervepathways.Anactiveb

2、rain-gutaxisfurtheraltersfunctioninregionsImmuneorganGastrointestinal-associatedlymphoidtissue,(GALT)CharacteristicsofDigestiveSystemNotonlyadigestiveorganbutalsoendocrineorganpancreasgastrin(胃泌素)glucagon(胰高糖素)somatostatin(生长抑素)VIP(血管活性肠肽)insulin(胰岛素)CharacteristicsofDigestiveSystemStructure/fun

3、ctionanddiseasesThebiggestorganHomeostasisSynthesisExcretionFilterDefensesymptomssignsDeathinflammation(炎症)Ulcer(溃疡)bleeding(出血)perforation(穿孔)neoplasm(肿瘤)functionaldisturbances(功能失调)CommonLesionsofDigestiveSystemClassificationofGIDiseasesImpairedDigestionandAbsorption(Biliaryobstruction,C

4、hronicpancreatitis)AlteredSecretion(Zollinger-Ellisonsyndrome,atrophicgastritis,smallintestinalbacterialovergrowth)AlteredGutTransit(obstructionbygastriccancerorcoloncancer,Achalasia,constipation,diarrhea)ImmuneDysregulation(ulcerativecolitis,Crohn’sdisease)ImpairedGutBloodFlow(intestinalandcolo

5、nicischemia)NeoplasticDegeneration(Esophageal,gastric,colon,pancreatic,biliarycancer)DisorderswithoutObviousOrganicAbnormalities(IBS)GeneticInfluencesClassificationofLiverDiseasesViralHepatitsNonalcoholicfattyliverAlcoholicliverdiseaseImmune&autoimmuneliverdiseasesDrug-inducedliverdiseaseGenetic

6、liverdiseasesMasslesionsVascularinjuryLiverinvolvementinsystemicdiseasesLaboratorytestsHistory+Symptoms+SignImagingstudiesEVALUATIONOFPATIENTWITHGIDISEASEThediagnosisdrivespredominantlyfromthepatient’shistoryThephysicianmustidentifythetiming,type,locationandseverityofthesymptoms,whenandwhereth

7、eyoccur,aggravatingandalleviatingfactors,andanyassociatedsymptoms.History&symptomsCardinalSymptomsofGIdiseasesAbdominalpain(GIandextraGI)(pepticulcer,appendicitis,IBD)Heartburn(gastroesophagealrefluxdisease,GERD)Nausea&Vomi